Provider Demographics
NPI:1053787952
Name:BERRIOS, AMARILYS
Entity type:Individual
Prefix:
First Name:AMARILYS
Middle Name:
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 482
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-0482
Mailing Address - Country:US
Mailing Address - Phone:787-368-1817
Mailing Address - Fax:
Practice Address - Street 1:301 AVE RAFAEL CORDERO
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5000
Practice Address - Country:US
Practice Address - Phone:787-368-1817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist